Physical Therapy Hard Cap Appeal

I work for a government entity, so my insurance is pretty good … minus the fact that I have 20 appointments of physical therapy per year. It’s not per condition, and it is a hard cap at 20.

Because of knee surgery & needing pelvic floor therapy, I used up all my PT by mid March. I’ve been essentially “saving” my PT appointments for pelvic floor, however, I met with an OBGYN last week who basically said that I NEED pelvic floor therapy. She’s prescribed a suppository to assist, however, there’s no replacement for “manual work” that needs to be done to help me relax my pelvic floor muscles.

I have one more appointment scheduled for mid August, and after that I’m cash pay ($221/15 minutes). I’m really trying to not change providers since pelvic floor therapy is extremely personal; however, even if I do switch providers, it’s still $150-200/appointment, which I also can’t really afford once a week (that will use up the rest of my FSA in 3-4 visits, and there is no payment plan available with this private clinic).

I’ve called the insurance company 4 times and there’s nothing that I can do. Has anyone had any luck in getting their employer to assist? Bloom (which is online PT) can’t assist because I need manual work, so, I’m at a loss on what to do. I won’t be able to afford $800-$1000 a month for PT, and PT is my ONLY option.

Would love to know if anyone else has been successful. I doubt it will work, but at this point, I’m desperate.

submitted by /u/legallymarms
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